E067 Paediatric rheumatology and timely access to non-inflammatory care: findings and recommendations from the Getting it Right First Time (GIRFT) Report

Abstract Background/Aims Non-inflammatory musculoskeletal pain is a common and important cause of paediatric morbidity and school absence. Early assessment and timely multidisciplinary intervention improves functional outcomes and reduces long-term impact. The 2025 paediatric rheumatology Getting It Right First Time (GIRFT) review, designed to identify and address unwarranted variation in care, presented a novel opportunity for a data-driven review of non-inflammatory care across the 16 tertiary paediatric rheumatology providers in England. Methods Patient-level Hospital Episode Statistics (HES), Referral to Treatment data and the associated Waiting List Minimum Dataset (WLMDS) were analysed for all outpatient paediatric rheumatology encounters between April 2023 and March 2024. These data were contextualised using self-reported data collected during the GIRFT peer review visits at the 16 providers. Results Between April 2023 and March 2024, the average number of paediatric rheumatology encounters per provider was 4862 (4184 out-patient and 678 in-patient attendances). There was a median length of 12.2 weeks from referral to first appointment (range 4.57-25.14). Six of the 16 tertiary centres reported outpatient diagnostic coding for approximately one-third of patients. Where diagnostic codes were recorded, approximately 75% of encounters were for patients with non-inflammatory conditions. Delays appear to be cumulative across the care pathway, compounding overall time from referral to treatment and increasing the risk of unmet need (Table 1). Conclusion Paediatric rheumatology outpatient diagnostic data, although limited, indicate that painful non-inflammatory presentations constitute a substantial proportion of encounters. Although national patient-level datasets currently lack the granularity to examine non-inflammatory community or hospital treatment pathways in detail, self-reported data from GIRFT peer review visits suggest that children and young people with non-inflammatory conditions experience delays accessing care throughout the pathway. An improved understanding of paediatric care pathways could inform data-driven improvements to non-inflammatory care, reducing functional impairment and school absence. Improving direct access to expert musculoskeletal therapy teams would divert children with non-inflammatory symptoms out of paediatric rheumatology services, improving timely access to non-inflammatory care close to home and allowing tertiary paediatric rheumatology MDTs to focus on specialised inflammatory care pathways. Disclosure F. McErlane: None. J. Clinch: None. S. Olson: None. C. Pidgeon: None. R.D. Sandler: None. C. Tranter: None. G. Ward: None. G. Cleary: None.